FORM 1023-EZ for 9TH ISLAND CULTURAL CLUB OF LAS VEGAS

Field Data
EIN 47-2415375
Case Number EO-2015159-000489
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name 9TH ISLAND CULTURAL CLUB OF LAS VEGAS
Organization’s Mailing Address PO BOX 46391
City LAS VEGAS
State NV
ZIP 89114
Accounting period End 12
Primary contact name HARTWELL KU JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMIE ESPRECION
PRESIDENT, DIRECTOR
PO BOX 46391
LAS VEGAS NV 89114

Officer/Director/Trustee Two

HARTWELL KU JR
SECRETARY, DIRECTOR
PO BOX 46391
LAS VEGAS NV 89114

Officer/Director/Trustee Three

CHELSIE KAKU
TREASURER, DIRECTOR
PO BOX 46391
LAS VEGAS NV 89114

Organization’s website WWW.9THICCOFLV.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/6/2015
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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